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Ventricular arrythmias
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Ventricular arrythmias

Hi!

I have three questions about ventricular arrythmias, questions
that I guess I share with many other readers of this forum.

1. Most PVCs are benign, I know that. However, if one has PVCs at rest, that don't disappear during excercise, is that a bad sign? Are infrequent PVCs during excercise something that is considered normal? Do you doctors often see that in healthy people or is PVCs during excercise a rare occurence?

2. I've read in medical books that young healthy people rarely have more than just a couple of PVCs per day. However, when reading this forum, I see young people having hundreds of PVCs per day, myself included. One doctor told me I had far too many PVCs for my age and sent me for evaluation, while another just told me PVCs are benign and nothing to worry about. What is your opinion about this issue?

3. A similiar question about Ventriular Tachycardia. I've read that this is a serious medical condition that needs a complete evaluation. However, I've also heard that this is a nearly normal phenomenon occuring in about 4 % of the population. What is true?

Fear is often a cause of ignorance, and I think many anxious hearts out there would be glad for an answer! Thank you!
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Avatar_n_tn
Hello Victic,
Good questions.

1. Most PVCs are benign, I know that. However, if one has PVCs at rest, that don't disappear during excercise, is that a bad sign? Are infrequent PVCs during excercise something that is considered normal? Do you doctors often see that in healthy people or is PVCs during excercise a rare occurence?

It is important to understand statistics when you read about this stuff.  I will you as extreme HYPOTHETICAL examples (these numbers are NOT accurate).  If the incidience of sudden death in a normal heart, young population is 1/1,000,000 and people with PVCs have suddend cardiac death at a rate of 2/1,000,000.  You could express this many different ways: 1. the incidence of sudden death in the normal heart PVC population is 1/500,000 (doesn't sound that bad) 2. there is a 200% increased incidence of sudden death in the normal heart PVC populations (sounds concerning).  This is two ways of presenting the same information that sounds very different.  I say this because the incidence of sudden death in young normal heart PVC population is VERY low.  The incidence of cardiac events is higher in the population that has PVCs at rest and during exercise, but is still VERY low.  PVCs cause symptoms and are therefore very hard to ignore, but believe me when I say that if we thought putting in ICDs or doing ablations would save lives or improve symptoms greater than the risk imposed of the procedure, we would do it.  In general, electrophysiologists like doing procedures and will do them if we have a good reason.  The incidence of cardiac events just isn't that high.


2. I've read in medical books that young healthy people rarely have more than just a couple of PVCs per day. However, when reading this forum, I see young people having hundreds of PVCs per day, myself included. One doctor told me I had far too many PVCs for my age and sent me for evaluation, while another just told me PVCs are benign and nothing to worry about. What is your opinion about this issue?

Normal heart PVCs are benign and should not be worried about.  It is important to have some comfortable with all the possibilities to evaluate you to make sure it is infact normal heart and not some obscure diagnosis that only specialists see.  I agree with specialists seeing PVC patients to make sure that it is just normal heart PVCs and/or knowing when these PVCs can be easily ablated from a typical right ventricular outflow tract location (only for very symptomatic people or people with cardiomypathy thought caused by PVCs).

3. A similiar question about Ventriular Tachycardia. I've read that this is a serious medical condition that needs a complete evaluation. However, I've also heard that this is a nearly normal phenomenon occuring in about 4 % of the population. What is true?

Again, this is an issue that should be evaluated by a specialist.  There are some normal heart VTs with a benign prognosis and can be easily treated with medications or ablation (RV outflow tract VT, exercise induced VT) -- this is most common in  young normal heart patients.  It is important to rule out structural, ischemic, metabolic or genetic cardiomyopathies that can cause VT.  Sometimes VT is the first symptoms, sometimes VT is a late symptoms.

Never forget that medicine is humbling for physicians and patients.  There is never a day that I don't learn something or see something new.

I hope this helps.  Thanks for posting.
5 Comments
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Avatar_n_tn
I too am anxious to hear an answer to this question.  My last holter monitor registered 700-800 events in a 24-hour period, and my doctor said not to worry, it wasn't life-threatening!
I feel every one of these mis-beats, and it has made my life miserable for 40 years, no conventional drug can touch it!
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Avatar_n_tn
threedogs, i think you just answered your own question, 40 years and they havent got you yet, its time to relax. I get the dreaded pvc/veb, I figure they still let me have a drivers licence, which they wouldnt allow if it was high risk.
And the other thing is most people with pvc/veb have had all the tests which i think makes us less likely to have sudden fatal cardiac event than anyone else i know i dont have heart disease or an under lying arrythmia problem, most people walking around and driving cars dont! And thanks for the forum it helps me to relax, especially hereing people with 40 years of ectopics.
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Avatar_n_tn
Well I'm also in the 'veteran's' club when it comes to PVCs. I've had them for about 30 years. Sometimes over 20,000 per day. Thats about every 3rd beat, for days and weeks on end. (they're quiet these day, thankfully) But I still get nervous when they crop up, I don't know if the fear ever actually goes away, but I can deal with them much better now. Had all the tests too, never did try any drugs. They just come and go on their own, so I really enjoy the times their gone!!
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Avatar_f_tn
Please see my post on the recent thread entitled "PVC'S are now constant" for an answer to your Question regarding the incidence of Vtach in the normal population.
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Avatar_f_tn
A related discussion, can I take myself off tambacor was started.
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